Healthcare Provider Details

I. General information

NPI: 1295548717
Provider Name (Legal Business Name): FEITIMA WASHINGTON PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 WOODLAKE VILLAGE CIR
MIDLOTHIAN VA
23112-2200
US

IV. Provider business mailing address

11 S 12TH ST # 2022
RICHMOND VA
23219-4053
US

V. Phone/Fax

Practice location:
  • Phone: 724-884-5492
  • Fax: 205-927-0854
Mailing address:
  • Phone: 724-884-5492
  • Fax: 205-927-0854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024192412
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: